Body Dysmorphic Disorder: CBT Can Help

body dysmorphic disorderResearchers at Rhode Island Hospital found that cognitive behavioral therapy (CBT) significantly improves the outcomes of patients who struggle with body dysmorphic disorder (BDD).[1] BDD is a common, and often severe, body image disorder in which a person is unable to cease thinking about “flaws” in their appearance.[2] Often, these flaws are minor or imagined. In fact, people with body dysmorphic disorder often obsess over their appearance and body image for hours a day, impacting their ability to function in daily life.2 The disease affects approximately 1.7 to 2.4 percent of the population.1

Researchers studied 36 adults who were diagnosed with body dysmorphic disorder, randomly selected to receive either 22 cognitive-behavioral therapy sessions over 24 weeks or a spot on a 12-week wait list.1 They found that CBT resulted in significant improvements in patients’ BDD symptoms and level of disability, as well as high patient satisfaction.1

Director of the Body Dysmorphic Disorder at Rhode Island Hospital, Katharine Phillips, M.D. said, “BDD is a common and often debilitating disorder, and there are very few proven effective treatments. This study suggests that using cognitive-behavioral therapy that specifically targets BDD symptoms can result in significant improvements in symptoms and ability to function in daily life.”1

As the study’s results were significant, Phillips and colleagues are currently conducting another study, funded by the National Institute of Mental Health, that will test the treatment more definitively and compare it to the most common types of therapy for BDD.1

With CBT, standard core elements that are relevant to all patients with body dysmorphic disorder are used, including psychoeducation, cognitive interventions, exposure to avoided situations, and prevention of excessive repetitive behaviors.1 At the end of treatment, relapse prevention strategies and booster sessions focus on helping patients to maintain the success they have achieved during treatment.1 There are also optional treatment modules available for patients that have certain symptoms and behaviors, such as compulsive skin picking or surgery seeking.1

While body dysmorphic disorder often begins during early adolescence, it is characterized by intrusive and time-consuming preoccupations regarding perceived defects in one’s physical appearance.1 For example, patients with BDD often obsess over their acne, hair loss, nose size, breast size, cellulite, etc.1 Others find the flaws minimal or even nonexistent.1

BDD also leads to social impairments, as the person is often too embarrassed by their appearance to go out into public, leading to missed work or school and difficulty forming meaningful relationships.1 People with body dysmorphic disorder often have high lifetime rates of psychiatric hospitalization and suicide attempts.1

Phillips said, “Cognitive-behavioral therapy is an often-helpful approach to treating BDD. It can be tailored to meet the needs of a wide range of patients and includes unique strategies to address symptoms that distinguish BDD from other disorders. While more research is needed, we conclude from this study that CBT is an appropriate, feasible, and very promising alternative treatment for those suffering from this often misunderstood and severe mental illness.”1

[1] Nauert, R. (2014). CBT Aids Patients with Body Dysmorphic Disorder. Psych Central. Retrieved on February 12, 2014, from http://psychcentral.com/news/2014/02/12/cbt-aids-patients-with-body-dysmorphic-disorder/65791.html

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